Department of Endocrinology-Diabetology and Nutrition, Mohammed VI University Hospital, Mohamed the First University, Oujda, Morocco.
Laboratory of Epidemiology, Clinical Research and Public Health, Mohamed the First University, Oujda, Morocco.
J Med Life. 2024 Jun;17(6):593-600. doi: 10.25122/jml-2024-0038.
A thyroid nodule is managed according to the clinical context, ultrasound (US) findings, and fine needle aspiration (FNA) results. Most thyroid nodules are benign; however, nodule classification is crucial to avoid unnecessary thyroid surgery. We conducted this study to compare the findings of fine-needle aspiration cytology (FNAC) expressed using the Bethesda system with the features of thyroid US classified using the EU-TIRADS classification to assess the risk of malignancy. A descriptive and analytical study involving 99 patients with thyroid nodules followed up in the Department of Endocrinology-Diabetology and Nutrition. Data were collected from medical records and analyzed using SPSS software V21. FNA was performed on 121 nodules using the BETHESDA system. These nodules were classified as malignant, suspicious for follicular neoplasm, and suspicious for malignancy in 5.8%, 5%, and 1.7% of cases, respectively. As for the EU-TIRADS 2017 classification, 59.5% of benign nodules were classified as EU-TIRADS III, whereas 66.7% of malignant nodules were classified as EU-TIRADS V and significantly related to malignant prediction ( = 0.000). The size of nodules was significantly correlated to the risk of malignancy ( = 0.013). Seventy-five percent of nodules with central vascularity were malignant ( = 0.012). Irregularity of nodule contours was significantly associated with the risk of malignancy, as 30% of nodules with irregular contours were Bethesda VI ( = 0.003). Hypoechogenicity was found in 77.8% of malignant nodules ( = 0.004). Additionally, only 9.2% of the nodules were taller than wide, of which 37.5% were malignant ( = 0.012). For a safe management strategy, US-guided FNAC should be performed on each suspicious thyroid nodule, given the correlation between EU-TIRADS classification features and the risk of malignancy.
甲状腺结节的处理依据临床情况、超声（US）表现和细针穿刺抽吸（FNA）结果而定。大多数甲状腺结节为良性，但结节分类对于避免不必要的甲状腺手术至关重要。本研究旨在比较使用 Bethesda 系统表达的细针抽吸细胞学（FNAC）结果与使用 EU-TIRADS 分类的甲状腺 US 特征，以评估恶性风险。一项描述性和分析性研究涉及在内分泌学-糖尿病和营养科随访的 99 例甲状腺结节患者。从病历中收集数据，并使用 SPSS 软件 V21 进行分析。使用 BETHESDA 系统对 121 个结节进行 FNA，这些结节分别有 5.8%、5%和 1.7%被归类为恶性、滤泡性肿瘤可疑和恶性可疑。至于 2017 年 EU-TIRADS 分类，59.5%的良性结节被归类为 EU-TIRADS III，而 66.7%的恶性结节被归类为 EU-TIRADS V，与恶性预测显著相关（=0.000）。结节大小与恶性风险显著相关（=0.013）。75%的中央血管化结节为恶性（=0.012）。结节轮廓不规则与恶性风险显著相关，因为 30%的不规则轮廓结节为 Bethesda VI（=0.003）。77.8%的恶性结节呈低回声（=0.004）。此外，只有 9.2%的结节高于宽，其中 37.5%为恶性（=0.012）。鉴于 EU-TIRADS 分类特征与恶性风险之间的相关性，对于每个可疑甲状腺结节，应进行超声引导下的 FNAC，以确保安全的管理策略。
